Provider Demographics
NPI:1952841157
Name:NEW JERSEY INSTITUTE FOR NEUROFEEDBACK AND NEUROTHERAPY
Entity Type:Organization
Organization Name:NEW JERSEY INSTITUTE FOR NEUROFEEDBACK AND NEUROTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HONEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STERZER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LCSW, BCN
Authorized Official - Phone:732-249-9800
Mailing Address - Street 1:317 CLEVELAND AVE STE 101A
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1817
Mailing Address - Country:US
Mailing Address - Phone:732-249-9800
Mailing Address - Fax:732-249-6300
Practice Address - Street 1:317 CLEVELAND AVE STE 101A
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1817
Practice Address - Country:US
Practice Address - Phone:732-249-9800
Practice Address - Fax:732-249-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05505500261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)